Neurosurgical treatment of craniopharyngioma in adults and children: early and long-term results in a large case series

J Neurosurg. 2011 May;114(5):1350-9. doi: 10.3171/2010.11.JNS10670. Epub 2011 Jan 7.


Object: Craniopharyngioma accounts for 2%-5% of all primary intracranial neoplasms. The optimal management of craniopharyngioma remains controversial. The authors evaluated the early results of surgery and the longterm risk of tumor recurrence in a large series of patients undergoing resection of craniopharyngiomas.

Methods: Between 1990 and 2008, 112 consecutive patients (57 male and 55 female patients with a mean [± SEM] age of 33.3 ± 1.8 years) underwent resection of craniopharyngiomas at the authors' hospital. Recurrence or growth of residual tumor tissue during follow-up was assessed using MR imaging.

Results: There were 3 perioperative deaths (2.7%). Severe adverse events were more frequent in patients who underwent operations via the transcranial route (37%) than the transsphenoidal approach (5.6%; p < 0.001). Magnetic resonance imaging showed radical resection of the tumor in 78 (71.6%) of the remaining 109 patients. Previous surgery and maximum tumor diameter were associated with persistence of disease after surgery. Craniopharyngioma recurred in 26 (24.5%) of 106 patients. Presence of residual tumor on the first postoperative MR imaging, male sex, and no postoperative radiation therapy were associated with a risk of tumor recurrence. Quality-of-life data were assessed in the 91 patients who attended the authors' institution for follow-up visits. Among them, 8.8% patients were partially or completely dependent on others for daily living activities before surgery. This percentage increased to 14.3% at the last follow-up visit. The 5- and 10-year overall survival rates were 94.4% (95% CI 90.0%-98.8%) and 90.3% (95% CI 83.4%-97.3%), respectively.

Conclusions: Complete surgical removal of craniopharyngioma can be achieved with reasonable safety in more than 70% of patients. Recurrence of craniopharyngioma may occur even after apparent radical excision. Prompt management of residual or recurring disease by radiotherapy, repeat surgery, or a combination of both is usually successful in controlling further tumor growth.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cause of Death
  • Child
  • Craniopharyngioma / diagnosis
  • Craniopharyngioma / mortality
  • Craniopharyngioma / surgery*
  • Craniotomy
  • Endoscopy
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / etiology
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm, Residual / diagnosis
  • Neoplasm, Residual / etiology
  • Neoplasm, Residual / mortality
  • Neoplasm, Residual / surgery
  • Pituitary Neoplasms / diagnosis
  • Pituitary Neoplasms / mortality
  • Pituitary Neoplasms / surgery*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology*
  • Postoperative Complications / mortality
  • Postoperative Complications / surgery
  • Quality of Life
  • Radiosurgery
  • Reoperation
  • Survival Rate
  • Tomography, X-Ray Computed